Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Correlation between Uterine Cervical Lesion and HPV in Busan Region

부산지역 여성의 자궁경부질환과 HPV의 상관관계

  • Son, Chang Min (Department of Pathology, Inje University Haeundae Paik Hospital) ;
  • Park, Chung Mu (Department of Biomedical Health Science, Graduate School of Dong-Eui University)
  • 손창민 (인제대학교 해운대백병원 병리과) ;
  • 박충무 (동의대학교 대학원 보건의과학과)
  • Received : 2019.07.05
  • Accepted : 2019.09.10
  • Published : 2019.12.31
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Abstract

This study was undertaken to investigate the distribution of human papillomavirus (HPV) subtypes and cervical lesions in Busan. Furthermore, the cytological and histological findings of cervical lesions were compared to determine the usefulness of the currently released vaccines. HPV subtypes of 2,130 patients who visited Haeundae Paik Hospital between January 2013 and March 2016 were analyzed by the HPV 9G DNA chip. Liquid-based cytological examination was performed, and subtypes were classified according to the 2001 guidelines of The Bethesda System. Biopsy or hysterectomy specimens were subjected to hematoxylin and eosin staining for histological examinations. Of the total 2,130 cases, 1,254 (58.9%) were positive for HPV, and 876 (41.1%) were negative. Of these, 152 (7.1%), 97 (4.6%) and 80 (3.8%) were identified as HPV 16, 68 and 56, respectively. Of the 329 cases encompassing the above three HPV subtypes, histopathological analysis diagnosed 155 (47.1%) cases with CIN2 or higher grade. Notably, the occurrences of HPV subtypes 16, 68, 56, 58 and 51 were most frequently diagnosed in Busan. Further analysis revealed that administration of GardasilⓇ 9, the currently available vaccine in the market, exerts no protection against subtypes 68, 59 and 51. This study aims to provide an important reference for future HPV vaccination programs in Busan.

2013년 1월부터 2016년 3월 사이 인제대학교 해운대백병원에 내원한 환자를 대상으로 HPV genotype 분석 후 세포학적 검사 결과, 조직학적 검사 결과와 비교하였다. 총 검사대상 2,130건 중 58.9%인 1,254건은 HPV 양성으로, 41.1%인 876건은 HPV 음성으로 분석되었다. HPV 양성검체 중 단순감염은 58.4%인 732건, 복합감염은 41.6%인 522건이었다. 감염비율은 HPV 16, 68, 56의 순으로 각각 7.1%인 152건, 4.6%인 97건, 3.8%인 80건으로 나타났다. HR HPV 감염은 40대, 30대, 50대 순으로 높은 감염률을 보였고, LR HPV 감염은 40대, 50대, 30대 순으로 높은 감염률을 보였다. 조직병리학적 분석 결과 CIN 2 이상으로 나온 HPV 16, 68, 56 건수는 329건 중 155건으로 47.1%(155/329)로 분석되었다. 부산지역 여성의 HPV subtype 감염은 주로 16, 68, 56, 58, 51과 관련이 있었으나, 이중 68, 56, 51형은 현재 시판 중인 GardasilⓇ 9가 백신으로도 예방할 수 없는 유전자형이었다. 이 연구를 통해 부산 지역의 HPV 예방 접종을 위한 프로그램에 대한 중요한 기준 데이터를 제공할 수 있을 것으로 사료된다.

Keywords

References

  1. Ferlay J, Soerjomataram I, Dikshit R, Ervik M, Mathers C, Rebelo M, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:359-386.
  2. Bray F, Ren JS, Masuyer E, Ferlay J. Global estimates of cancer prevalence for 27 sites in the adult population in 2008. Int J Cancer. 2013;132:1133-1145. https://doi.org/10.1002/ijc.27711
  3. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Pineros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144:1941-1953. https://doi.org/10.1002/ijc.31937
  4. Cho H, Lee DW, Choe YJ, Choe SA, Park NY. Publication of the Korea-WHO cooperation history - 70 years of working together for heath: world health organization and the Republic of Korea. J Korean Med Sci. 2017;32:383-385. https://doi.org/10.3346/jkms.2017.32.3.383
  5. Ronco G, Giorgi-Rossi P, Carozzi F, Confortini M, Dalla Palma P, Del Mistro A, et al. New technologies for cervical Cancer screening (NTCC) working group: efficacy of human papillomavirus testing for the detection of invasive cervical cancer and cervical intraepithelial neoplasia: a randomised controlled trial. Lancet Oncol. 2010;11:249-257. https://doi.org/10.1016/S1470-2045(09)70360-2
  6. Cox JT, Castle PE, Behrens CM, Sharma A, Wright TC Jr, Cuzick J. Comparison of cervical cancer screening strategies incorporating different combinations of cytology, HPV testing, and genotyping for HPV 16/18: results from the ATHENA HPV study. Am J Obstet Gynecol. 2013;208:184E1-184E11. https://doi.org/10.1016/j.ajog.2012.11.020
  7. Castle PE, Stoler MH, Wright TC Jr, Sharma A, Wright TL, Behrens CM. Performance of carcinogenic human papillomavirus (HPV) testing and HPV16 or HPV18 genotyping for cervical cancer screening of women aged 25 years and older: a subanalysis of the ATHENA study. Lancet Oncol. 2011;12:880-890. https://doi.org/10.1016/S1470-2045(11)70188-7
  8. Park SM, Lee SK, Kim YS. Inhibition of cervical cancer cell growth by gene silencing of HPV16 E6 Induced by short-interfering RNA. Korean J Clin Lab Sci. 2011;43:89-97.
  9. Lee JB, Park CE. Investigation of detected by recent various human papillomavirus from general hospital in Seoul area. Korean J Clin Lab Sci. 2016;48:247-254. https://doi.org/10.15324/kjcls.2016.48.3.247
  10. Bauer H, Hildesheim A, Schiffman NH. Determinants of genital human papillomavirus infection in low-risk women Portland, Oregon. Sex Transm Dis. 1993;20:274-278. https://doi.org/10.1097/00007435-199309000-00007
  11. Cuzick J. Gardasil 9 joins the fight against cervix cancer. Expert Rev Vaccines 2015;14:1047-1049. https://doi.org/10.1586/14760584.2015.1051470
  12. Forman D, de Martel C, Lacey CJ, Soerjomataram I, Lortet-Tieulent J, Bruni L, et al. Global burden of human papillomavirus and related diseases. Vaccine. 2012;30(Suppl 5):12-23.
  13. Franceschi S, Denny L, Irwin KL, Jeronimo J, Lopalco PL, Monsonego J, et al. EUROGIN 2010 roadmap on cervical cancer prevention. Int J Cancer 2011;128:2765-2774. https://doi.org/10.1002/ijc.25915
  14. Huh WK, Ault KA, Chelmow D, Davey DD, Goulart RA, Garcia FA, et al. Use of primary high-risk human papillomavirus testing for cervical cancer screening: Interim clinical guideline. Obstet Gynecol. 2015;125:330-337. https://doi.org/10.1097/AOG.0000000000000669
  15. Li N, Franceschi S, Howell-Jones R, Snijders PJ, Clifford GM. Human papillomavirus type distribution in 30,848 invasive cervical cancers worldwide: Variation by geographical region, histological type and year of publication. Int J Cancer 2011;128:927-935. https://doi.org/10.1002/ijc.25396
  16. Solomon D, Davey D, Kurman R, Moriarty A, O'Connor D, Prey M. The Bethesda System 2001: terminology for reporting the results of cervical. JAMA. 2002;287:2114- 2119. https://doi.org/10.1001/jama.287.16.2114
  17. Chan PK, Li WH, Chan MY, Ma WL, Cheung JL, Cheng AF. High prevalence of human papillomavirus type 58 in Chinese women with cervical cancer and precancerous lesions. J Med Virol. 1999;59:232-238. https://doi.org/10.1002/(SICI)1096-9071(199910)59:2<232::AID-JMV18>3.0.CO;2-7
  18. Bosch FX, Munoz N. The viral etiology of cervical cancer. Virus Res. 2002;89:183-190. https://doi.org/10.1016/S0168-1702(02)00187-9
  19. Ronco G, Giorgi-Rossi P, Carozzi F, Confortini M, Dalla Palma P, Del Mistro A, et al. Efficacy of human papillomavirus testing for the detection of invasive cervical cancer and cervical intraepithelial neoplasia: A randomised controlled trial. Lancet Oncol. 2010;11:249-257. https://doi.org/10.1016/S1470-2045(09)70360-2
  20. de Sanjose S, Quint WG, Alemany L, Geraets DT, Klaustermeier JE, Lloveras B, et al. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol. 2010;11:1048-1056. https://doi.org/10.1016/S1470-2045(10)70230-8
  21. Wright TC Jr, Massad LS, Dunton CJ, Spitzer M, Wilkinson EJ, Solomon D. et al. 2006 Consensus guidelines for the management of women with abnormal cervical cancer screening tests. Am J Obstet Gynecol. 2007;197:346-355. https://doi.org/10.1016/j.ajog.2007.07.047
  22. Committee on Practice Bulletins-Gynecology: ACOG practice bulletin number 131: Screening for cervical cancer. Obstet Gynecol. 2012;120:1222-1238. https://doi.org/10.1097/AOG.0b013e318277c92a
  23. Hang D, Jia M, Ma H, Zhou J, Feng X, Lyu Z, et al. Independent prognostic role of human papillomavirus genotype in cervical cancer. BMC Infect Dis. 2017;17:391. https://doi.org/10.1186/s12879-017-2465-y
  24. So KA, Hong JH, Lee JK. Human papillomavirus prevalence and type distribution among 968 women in South Korea. J Cancer Prev. 2016;21:104-109. https://doi.org/10.15430/JCP.2016.21.2.104
  25. Kim S, Lee IS, Lee D. Human papillomavirus prevalence and genotype distribution in normal and ASCUS specimens: comparison of a reverse blot hybridization assay with a DNA chip test. Biomed Sci Lett. 2015;21:32-39. https://doi.org/10.15616/BSL.2015.21.1.32
  26. Kim SH, Lee DS, Kim Y, Kim GH, Park SJ, Choi YI, et al. Clinical evaluation of human papillomavirus DNA genotyping assay to Diagnose Women Cervical Cancer. Biomed Sci Lett. 2012;18:123-130.
  27. Cho NH, An HJ, Jeong JK, Kang S, Kim JW, Kim YT, et al. Genotyping of 22 human papillomavirus types by DNA chip in korean women: comparison with cytologic diagnosis. Am J Obstet Gynecol. 2003;188:56-62. https://doi.org/10.1067/mob.2003.120
  28. Hwang TS, Jeong JK, Park M, Han HS, Choi HK, Park TS. Detection and typing of HPV genotypes in various cervical lesions by HPV oligonucleotide microarray. Gynecol Oncol. 2003;90:51-56. https://doi.org/10.1016/S0090-8258(03)00201-4
  29. Meng YH1, Li S, Hu T, Ma D, Lu YP, Wang H. Clinical analysis of 132 cases of cervical adenosquamous carcinoma and cervical adenocarcinoma. Chin J Cancer. 2010;29:15-19. https://doi.org/10.5732/cjc.009.10143